Search results for: clinical error

Authors: Sokol Isaraj, Lorela Bendo

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Scars resulting from surgery, injury, or burns have a physical and psychological impact on the affected patient. Although a number of treatments are available, nano fat grafting is an effective treatment for scars. Nano fat is a liquid suspension rich in stem cells obtained by mechanical emulsification. Nano fat grafting was performed in 10 cases to correct rhytides, surgical scars and post-burn scars between January 2022 and April 2022. Fat was aspirated from the lower abdomen or trochanteric region. After emulsification and filtration protocol, the resulting nano fat liquid was injected intradermally and subdermally. All patients filled out a questionnaire at 3 months post-treatment which consisted of questions regarding the grade of improvement of skin and recommendation of the procedure. The clinical results were apparent between 2 and 3 weeks after the treatment. All patients confirmed an improvement in skin texture and quality. The most significant improvement was seen in pigmentation and pliability. No complications were reported. Nano fat seems to be a safe and effective treatment for scar treatment and skin rejuvenation.

Keywords: fat grafting, fat transfer, microfat, nanofat

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Authors: Nana Adjoah Mbroh, Suares Clovis Oukouomi Noutchie

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Singularly perturbed problems are parameter dependent problems, and they play major roles in the modelling of real-life situational problems in applied sciences. Thus, designing efficient numerical schemes to solve these problems is of much interest since the exact solutions of such problems may not even exist. Generally, singularly perturbed problems are identified by a small parameter multiplying at least the highest derivative in the equation. The presence of this parameter causes the solution of these problems to be characterized by rapid oscillations. This unique feature renders classical numerical schemes inefficient since they are unable to capture the behaviour of the exact solution in the part of the domain where the rapid oscillations are present. In this paper, a numerical scheme is proposed to solve a singularly perturbed Volterra Integro-differential equation. The scheme is based on the midpoint rule and employs the non-standard finite difference scheme to solve the differential part whilst the composite trapezoidal rule is used for the integral part. A fully fledged error estimate is performed, and Richardson extrapolation is applied to accelerate the convergence of the scheme. Numerical simulations are conducted to confirm the theoretical findings before and after extrapolation.

Keywords: midpoint rule, non-standard finite difference schemes, Richardson extrapolation, singularly perturbed problems, trapezoidal rule, uniform convergence

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Authors: Ki-Yeo Kim

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Trends in genetics are transforming in order to identify differential coexpressions of correlated gene expression rather than the significant individual gene. Moreover, it is known that a combined biomarker pattern improves the discrimination of a specific cancer. The identification of the combined biomarker is also necessary for the early detection of invasive oral squamous cell carcinoma (OSCC). To identify the combined biomarker that could improve the discrimination of OSCC, we explored an appropriate number of genes in a combined gene set in order to attain the highest level of accuracy. After detecting a significant gene set, including the pre-defined number of genes, a combined expression was identified using the weights of genes in a gene set. We used the Principal Component Analysis (PCA) for the weight calculation. In this process, we used three public microarray datasets. One dataset was used for identifying the combined biomarker, and the other two datasets were used for validation. The discrimination accuracy was measured by the out-of-bag (OOB) error. There was no relation between the significance and the discrimination accuracy in each individual gene. The identified gene set included both significant and insignificant genes. One of the most significant gene sets in the classification of normal and OSCC included MMP1, SOCS3 and ACOX1. Furthermore, in the case of oral dysplasia and OSCC discrimination, two combined biomarkers were identified. The combined genomic expression achieved better performance in the discrimination of different conditions than in a single significant gene. Therefore, it could be expected that accurate diagnosis for cancer could be possible with a combined biomarker.

Keywords: oral squamous cell carcinoma, combined biomarker, microarray dataset, correlated genes

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Authors: Chieh-Ning Lan, Tzu-Shin Lin, Kun-Hao Lin

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Chinese handwriting skill is one of the basic skills of school-age children in Taiwan, which helps them to learn most academic subjects. Differ from the alphabetic language system, Chinese written language is a logographic script with a complicated 2-dimensional character structure as a morpheme. Visuospatial ability places a great role in Chinese handwriting to maintain good proportion and alignment of these interwoven strokes. In Taiwan, school-age students faced the challenge to recognize and write down Chinese characters, especially in children with written expression difficulties (CWWDs). In this study, we developed an instructional app to help CWWDs practice Chinese handwriting skills, and we aimed to apply the mobile assisted language learning (MALL) system in clinical writing strategies. To understand the feasibility and satisfaction of this auxiliary instructional writing app, we investigated the perceive and value both from school-age students and the clinic therapists, who were the target users and the experts. A group of 8 elementary school children, as well as 8 clinic therapists, were recruited. The school-age students were asked to go through a paper-based instruction and were asked to score the visual expression based on their graphic preference; the clinic therapists were asked to watch an introductive video of this instructional app and complete the online formative questionnaire. In the results of our study, from the perspective of user interface design, school-age students were more attracted to cartoon-liked pictures rather than line drawings or vivid photos. Moreover, compared to text, pictures which have higher semantic transparency were more commonly chosen by children. In terms of the quantitative survey from clinic therapists, they were highly satisfied with this auxiliary instructional writing app, including the concepts such as visual design, teaching contents, and positive reinforcement system. Furthermore, the qualitative results also suggested comprehensive positive feedbacks on the teaching contents and the feasibility of integrating the app into clinical treatments. Interestingly, we found that clinic therapists showed high agreement in approving CWWDs’ writing ability with using orthographic knowledge; however, in the qualitative section, clinic therapists pointed out that CWWDs usually have relative insufficient background knowledge in Chinese character orthographic rules, which because it is not a key-point in conventional handwriting instruction. Also, previous studies indicated that conventional Chinese reading and writing instructions were lacked of utilizing visual-spatial arrangement strategies. Based on the sharing experiences from all participants, we concluded several interesting topics that are worth to dedicate to in the future. In this undergoing app system, improvement and revision will be applied into the system design, and will establish a better and more useful instructional system for CWWDs within their treatments; enlightened by the opinions related to learning content, the importance of orthographic knowledge in Chinese character recognition should be well discussed and involved in CWWDs’ intervention in the future.

Keywords: auxiliary instructional app, children with writing difficulties, Chinese handwriting, orthographic knowledge

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Authors: A. F. C. Nassar, D. K. Tessler, L. Okuda, C. Del Fava, D. P. Chiebao, A. H. C. N. Romaldini, A. P. Alvim, M. J. Sanchez-Vazquez, M. S. Rosa, J. C. Pompei, R. Harakava, M. C. S. Araujo, G. H. F. Marques, E. M. Pituco

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Glanders is a zoonotic disease of Equidae caused by the bacterium Burkholderia mallei presented in acute or chronic clinical forms with inflammatory nodules in the respiratory tract, lymphangitis and caseous lymph nodes. There is not a treatment with veterinary drugs to this life-threatening disease; thus, its occurrence must be notified to official animal health services and any infected animal must be eliminated. This study aims to detect B. mallei from horses euthanized in outbreaks of glanders in Brazil, providing a better understanding of the bacterial characteristics and determine a proper protocol for isolation. The work was carried out with the collaboration of the Ministry of Agriculture and the Sao Paulo State Animal Health Department, while its procedures were approved by the Committee of Ethics in Animal Experimentation from the Instituto Biologico (CETEA n°156/2017). To the present time, 16 horses from farms with outbreaks of glanders detected by complement fixation test (CFT) serology method were analyzed. During the necropsy, samples of possibly affected organs (lymph nodes, lungs, heart, liver, spleen, kidneys and trachea) were collected for bacterial isolation, molecular tests and pathology. Isolation was performed using two enriched mediums, a potato infusion agar with 5% sheep blood, 4% glycerol and antibiotics (penicilin100U/ mL), and another with the same ingredients except the antibiotic. A PCR protocol was modified for this study using primers design to identify a region of the Flip gen of B. mallei. Thru isolation, 12.5% (2/16) animals were confirmed positive using only the enriched medium with antibiotic and confirmed by PCR: from mediastinal and submandibular lymph nodes and lungs in one animal and from mediastinal lymph node in the other. The detection of the bacterium using PCR showed positivity of 100% (16/16) horses from 144 samples of organs. Pathology macroscopic lesions observed were catarrhal nasal discharge, fetlock ulcers, emaciation, lymphangitis in limbs, suppurative lymphangitis, lymph node enlargement, star shaped liver, and spleen scars, adherence of the renal capsule, pulmonary hemorrhage, and miliary nodules. Microscopic lesions were suppurative bronchopneumonia with microabscesses and Langhans giant cells in lungs; lymph nodes with abscesses and intense lymphoid reaction; hemosiderosis and abscesses in spleen. Positive samples on PCR will be sequenced later and analyzed comparing with previous records in the literature. A throughout description of the recent acute cases of glanders occurring in Brazil and characterization of the bacterium related will contribute to advances in the knowledge of the pathogenicity, clinical symptoms, and epidemiology of this zoonotic disease. Acknowledgment: This project is sponsored by FAPESP.

Keywords: equines, bacterial isolation, zoonosis, PCR, pathology

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Authors: Shubham Jaiswal

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During modelling of many physical problems and engineering processes, fractional calculus plays an important role. Those are greatly described by fractional differential equations (FDEs). So a reliable and efficient technique to solve such types of FDEs is needed. In this article, a numerical solution of a class of fractional differential equations namely space fractional order reaction-advection dispersion equations subject to initial and boundary conditions is derived. In the proposed approach shifted Jacobi polynomials are used to approximate the solutions together with shifted Jacobi operational matrix of fractional order and spectral collocation method. The main advantage of this approach is that it converts such problems in the systems of algebraic equations which are easier to be solved. The proposed approach is effective to solve the linear as well as non-linear FDEs. To show the reliability, validity and high accuracy of proposed approach, the numerical results of some illustrative examples are reported, which are compared with the existing analytical results already reported in the literature. The error analysis for each case exhibited through graphs and tables confirms the exponential convergence rate of the proposed method.

Keywords: space fractional order linear/nonlinear reaction-advection diffusion equation, shifted Jacobi polynomials, operational matrix, collocation method, Caputo derivative

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Authors: Ahmed Mahmoud Ahmed Abouelmagd

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The diversity is the usual remedy of the transmitted signal level variations (Fading phenomena) in radio frequency channels. Diversity techniques utilize two or more copies of a signal and combine those signals to combat fading. The basic concept of diversity is to transmit the signal via several independent diversity branches to get independent signal replicas via time – frequency - space - and polarization diversity domains. Coding and decoding processes can be an alternative remedy for fading phenomena, it cannot increase the channel capacity, but it can improve the error performance. In this paper we propose the use of replication decoding with BCH code class, and Viterbi decoding algorithm with convolution coding; as examples of coding and decoding processes. The results are compared to those obtained from two optimized selection space diversity techniques. The performance of Rayleigh fading channel, as the model considered for radio frequency channels, is evaluated for each case. The evaluation results show that the coding and decoding approaches, especially the BCH coding approach with replication decoding scheme, give better performance compared to that of selection space diversity optimization approaches. Also, an approach for combining the coding and decoding diversity as well as the space diversity is considered, the main disadvantage of this approach is its complexity but it yields good performance results.

Keywords: Rayleigh fading, diversity, BCH codes, Replication decoding, ‎convolution coding, viterbi decoding, space diversity

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Authors: Andreas Latz, Daniela Heinz, Fatima Hashemi, Melek Baygül

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Introduction: Feline leukemia virus (FeLV), feline immunodeficiency virus (FIV), and feline coronavirus (FCoV) are serious infectious diseases affecting cats worldwide. Transmission of these viruses occurs primarily through close contact with infected cats (via saliva, nasal secretions, faeces, etc.). FeLV, FIV, and FCoV infections can occur in combination and are expressed in similar clinical symptoms. Diagnosis can therefore be challenging: Symptoms are variable and often non-specific. Sick cats show very similar clinical symptoms: apathy, anorexia, fever, immunodeficiency syndrome, anemia, etc. Sample volume for small companion animals for diagnostic purposes can be challenging to collect. In addition, multiplex diagnosis of diseases can contribute to an easier, cheaper, and faster workflow in the lab as well as to the better differential diagnosis of diseases. For this reason, we wanted to develop a new diagnostic tool that utilizes less sample volume, reagents, and consumables than multiplesingleplex ELISA assays Methods: The Multiplier from Dynextechonogies (USA) has been used as platform to develop a Multiplex diagnostic tool for the detection of antibodies against FIV and FCoV/FIP and antigens for FeLV. Multiplex diagnostics. The Dynex®Multiplier®is a fully automated chemiluminescence immunoassay analyzer that significantly simplifies laboratory workflow. The Multiplier®ease-of-use reduces pre-analytical steps by combining the power of efficiently multiplexing multiple assays with the simplicity of automated microplate processing. Plastic beads have been coated with antigens for FIV and FCoV/FIP, as well as antibodies for FeLV. Feline blood samples are incubated with the beads. Read out of results is performed via chemiluminescence Results: Bead coating was optimized for each individual antigen or capture antibody and then combined in the multiplex diagnostic tool. HRP: Antibody conjugates for FIV and FCoV antibodies, as well as detection antibodies for FeLV antigen, have been adjusted and mixed. 3 individual prototyple batches of the assay have been produced. We analyzed for each disease 50 well defined positive and negative samples. Results show an excellent diagnostic performance of the simultaneous detection of antibodies or antigens against these feline diseases in a fully automated system. A 100% concordance with singleplex methods like ELISA or IFA can be observed. Intra- and Inter-Assays showed a high precision of the test with CV values below 10% for each individual bead. Accelerated stability testing indicate a shelf life of at least 1 year. Conclusion: The new tool can be used for multiplex diagnostics of the most important feline infectious diseases. Only a very small sample volume is required. Fully automation results in a very convenient and fast method for diagnosing animal diseases.With its large specimen capacity to process over 576 samples per 8-hours shift and provide up to 3,456 results, very high laboratory productivity and reagent savings can be achieved.

Keywords: Multiplex, FIV, FeLV, FCoV, FIP

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Authors: Abdullahi Jibrin, Aishetu Abdulkadir

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The development of allometric models is crucial to accurate forest biomass/carbon stock assessment. The aim of this study was to develop a set of biomass prediction models that will enable the determination of total tree aboveground biomass for savannah woodland area in Niger State, Nigeria. Based on the data collected through biometric measurements of 1816 trees and destructive sampling of 36 trees, five species specific and one site specific models were developed. The sample size was distributed equally between the five most dominant species in the study site (Vitellaria paradoxa, Irvingia gabonensis, Parkia biglobosa, Anogeissus leiocarpus, Pterocarpus erinaceous). Firstly, the equations were developed for five individual species. Secondly these five species were mixed and were used to develop an allometric equation of mixed species. Overall, there was a strong positive relationship between total tree biomass and the stem diameter. The coefficient of determination (R2 values) ranging from 0.93 to 0.99 P < 0.001 were realised for the models; with considerable low standard error of the estimates (SEE) which confirms that the total tree above ground biomass has a significant relationship with the dbh. The F-test value for the biomass prediction models were also significant at p < 0.001 which indicates that the biomass prediction models are valid. This study recommends that for improved biomass estimates in the study site, the site specific biomass models should preferably be used instead of using generic models.

Keywords: allometriy, biomass, carbon stock , model, regression equation, woodland, inventory

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Authors: Soyoon Bak, Sunyoung Bu, Philsu Kim

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In this paper, a backward semi-Lagrangian scheme combined with the second-order backward difference formula is designed to calculate the numerical solutions of nonlinear advection-diffusion equations. The primary aims of this paper are to remove any iteration process and to get an efficient algorithm with the convergence order of accuracy 2 in time. In order to achieve these objects, we use the second-order central finite difference and the B-spline approximations of degree 2 and 3 in order to approximate the diffusion term and the spatial discretization, respectively. For the temporal discretization, the second order backward difference formula is applied. To calculate the numerical solution of the starting point of the characteristic curves, we use the error correction methodology developed by the authors recently. The proposed algorithm turns out to be completely iteration-free, which resolves the main weakness of the conventional backward semi-Lagrangian method. Also, the adaptability of the proposed method is indicated by numerical simulations for Burgers’ equations. Throughout these numerical simulations, it is shown that the numerical results are in good agreement with the analytic solution and the present scheme offer better accuracy in comparison with other existing numerical schemes. Semi-Lagrangian method, iteration-free method, nonlinear advection-diffusion equation, second-order backward difference formula

Keywords: Semi-Lagrangian method, iteration free method, nonlinear advection-diffusion equation, second-order backward difference formula

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Authors: Manveen Singh

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Since the very advent of law enforcement, eyewitness testimony has played a pivotal role in identifying, arresting and convicting suspects. Reliant heavily on the accuracy of human memory, nothing seems to carry more weight with the judiciary than the testimony of an actual witness. The acceptance of eyewitness testimony as a substantive piece of evidence lies embedded in the assumption that the human mind is adept at recording and storing events. Research though, has proven otherwise. Having carried out extensive study in the field of eyewitness testimony for the past 40 years, psychologists have concluded that human memory is fragile and needs to be treated carefully. The question that arises then, is how reliable is eyewitness testimony? The credibility of eyewitness testimony, simply put, depends on several factors leaving it reliable at times while not so much at others. This is further substantiated by the fact that as per scientific research, over 75 percent of all eyewitness testimonies may stand in error; quite a few of these cases resulting in life sentences. Although the advancement of scientific techniques, especially DNA testing, helped overturn many of these eyewitness testimony-based convictions, yet eyewitness identifications continue to form the backbone of most police investigations and courtroom decisions till date. What then is the solution to this long standing concern regarding the accuracy of eyewitness accounts? The present paper shall analyze the linkage between human memory and eyewitness identification as well as look at the various factors governing the credibility of eyewitness testimonies. Furthermore, it shall elaborate upon some best practices developed over the years to help reduce mistaken identifications. Thus, in the process, trace out the changing landscape of eyewitness testimony amidst the evolution of DNA and trace evidence.

Keywords: DNA, eyewitness, identification, testimony, evidence

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Authors: A. M. Tiara, Sudipto Chakraborty, S. K. Pal

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Impinging jets and their different configurations are important from the viewpoint of the fluid flow characteristics and their influence on heat transfer from metal surfaces due to their complex flow characteristics. Such flow characteristics results in highly variable heat transfer from the surface, resulting in varying cooling rates which affects the mechanical properties including hardness and strength. The overall objective of the current research is to conduct a fundamental investigation of the heat transfer mechanisms for an impinging coolant jet. Numerical simulation of the cooling process gives a detailed analysis of the different parameters involved even though employing Computational Fluid Dynamics (CFD) to simulate the real time process, being a relatively new research area, poses many challenges. The heat transfer mechanism in the current research is actuated by jet cooling. The computational tool used in the ongoing research for simulation of the cooling process is ANSYS Workbench software. The temperature and heat flux distribution along the steel strip with the effect of various flow parameters on the heat transfer rate can be observed in addition to determination of the jet impingement patterns, which is the major aim of the present analysis. Modelling both jet and air atomized cooling techniques using CFD methodology and validating with those obtained experimentally- including trial and error with different models and comparison of cooling rates from both the techniques have been included in this work. Finally some concluding remarks are made that identify some gaps in the available literature that have influenced the path of the current investigation.

Keywords: CFD, heat transfer, impinging jets, numerical simulation

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Authors: Avinash Kharel

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Recreational soccer (RS) as a medium of small-sided soccer game (SSG) has an immense positive effect on physical health, mental health and wellbeing. The RS has reflected both acute responses and long-term effects of training on sedentary, trained and clinical population on any age, gender or health status. The enjoyable mode of training elicits greater adherence by optimising intrinsic motivation while offering health benefits that match those achieved by treadmill and cycle ergometer programmes both as continuous and interval forms of training. Additionally, recreational soccer is effective and efficient regimens with highlighted social, motivational and competitive components overcoming the barriers such as cost-efficiency, time-efficiency, assess to facilities and intrinsic motivation. Further, it can be applied as an effective broad-spectrum non-pharmacological treatment of lifestyle diseases producing a positive physiological response in healthy subjects, patients and elderly people regardless of age, gender or training experience.

Keywords: recreational soccer, health benefits, diseases prevention, physiology

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Authors: Thanduxolo Elford Fana

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Rationale and Purpose: Performance management and development system are central to effective and efficient service delivery, especially in highly labour intensive sectors such as South African public health. Performance management and development systems seek to ensure that good employee performance is rewarded accordingly, while those who underperform are developed so that they can reach their full potential. An effective and efficiently implemented performance management system motivates and improves employee engagement. The purpose of this study is to examine the implementation of the performance management and development system and the challenges that are encountered during its implementation in the Eastern Cape Provincial Department of Health. Methods: A qualitative research approach and a case study design was adopted in this study. The primary data were collected through observations, focus group discussions with employees, a group interview with shop stewards, and in-depth interviews with supervisors and managers, from April 2019 to September 2019. There were 45 study participants. In-depth interviews were held with 10 managers at facility level, which included chief executive officer, chief medical officer, assistant director’s in human resources management, patient admin, operations, finance, and two area manager and two operation managers nursing. A group interview was conducted with five shop stewards and an in-depth interview with one shop steward from the group. Five focus group discussions were conducted with clinical and non-clinical staff. The focus group discussions were supplemented with an in-depth interview with one person from each group in order to counter the group effect. Observations included moderation committee, contracting, and assessment meetings. Findings: The study shows that the performance management and development system was not properly implemented. There was non-compliance to performance management and development system policy guidelines in terms of time lines for contracting, evaluation, payment of incentives to good performers, and management of poor performance. The study revealed that the system is ineffective in raising the performance of employees and unable to assist employees to grow. The performance bonuses were no longer paid to qualifying employees. The study also revealed that lack of capacity and commitment, poor communication, constant policy changes, financial constraints, weak and highly bureaucratic management structures, union interference were challenges that were encountered during the implementation of the performance management and development system. Lastly, employees and supervisors were rating themselves three irrespective of how well or bad they performed. Conclusion: Performance management is regarded as vital to improved performance of the health workforce and healthcare service delivery among populations. Effective implementation of performance management and development system depends on well-capacitated and unbiased management at facility levels. Therefore, there is an urgent need to improve communication, link performance management to rewards, and capacitate staff on performance management and development system, as it is key to improved public health sector outcomes or performance.

Keywords: challenges, implementation, performance management and development system, public hospital

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Authors: Emmanuel Okechukwu Nwafor, Folake Olubunmi Akintayo, Denis Alcides Rezende

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Decision tree models are versatile and interpretable machine learning algorithms widely used for both classification and regression tasks, which can be related to cities, whether physical or digital. The aim of this research is to assess how well decision tree algorithms can predict trip purposes in Makurdi, Nigeria, while also exploring their connection to the strategic digital city initiative. The research methodology involves formalizing household demographic and trips information datasets obtained from extensive survey process. Modelling and Prediction were achieved using Python Programming Language and the evaluation metrics like R-squared and mean absolute error were used to assess the decision tree algorithm's performance. The results indicate that the model performed well, with accuracies of 84% and 68%, and low MAE values of 0.188 and 0.314, on training and validation data, respectively. This suggests the model can be relied upon for future prediction. The conclusion reiterates that This model will assist decision-makers, including urban planners, transportation engineers, government officials, and commuters, in making informed decisions on transportation planning and management within the framework of a strategic digital city. Its application will enhance the efficiency, sustainability, and overall quality of transportation services in Makurdi, Nigeria.

Keywords: decision tree algorithm, trip purpose, intelligent transport, strategic digital city, travel pattern, sustainable transport

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Authors: Diane Ghanem, Arjun Gupta, Rohan Vijayan, Ali Uneri, Babar Shafiq

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Introduction: Ankle sprains and fractures often result in syndesmosis injuries. Unstable syndesmotic injuries result from relative motion between the distal ends of the tibia and fibula, anatomic juncture which should otherwise be rigid, and warrant operative management. Clinical and radiological evaluations of intraoperative syndesmosis stability remain a challenging task as traditional 2D fluoroscopy is limited to a uniplanar translational displacement. The purpose of this pilot cadaveric study is to compare the 2D fluoroscopy and 3D cone beam computed tomography (CBCT) stress-induced syndesmosis displacements. Methods: Three fresh-frozen lower legs underwent 2D fluoroscopy and 3D CIOS CBCT to measure syndesmosis position before dissection. Syndesmotic injury was simulated by resecting the (1) anterior inferior tibiofibular ligament (AITFL), the (2) posterior inferior tibiofibular ligament (PITFL) and the inferior transverse ligament (ITL) simultaneously, followed by the (3) interosseous membrane (IOM). Manual external rotation and Cotton stress test were performed after each of the three resections and 2D and 3D images were acquired. Relevant 2D and 3D parameters included the tibiofibular overlap (TFO), tibiofibular clear space (TCS), relative rotation of the fibula, and anterior-posterior (AP) and medial-lateral (ML) translations of the fibula relative to the tibia. Parameters were measured by two independent observers. Inter-rater reliability was assessed by intraclass correlation coefficient (ICC) to determine measurement precision. Results: Significant mismatches were found in the trends between the 2D and 3D measurements when assessing for TFO, TCS and AP translation across the different resection states. Using 3D CBCT, TFO was inversely proportional to the number of resected ligaments while TCS was directly proportional to the latter across all cadavers and ‘resection + stress’ states. Using 2D fluoroscopy, this trend was not respected under the Cotton stress test. 3D AP translation did not show a reliable trend whereas 2D AP translation of the fibula was positive under the Cotton stress test and negative under the external rotation. 3D relative rotation of the fibula, assessed using the Tang et al. ratio method and Beisemann et al. angular method, suggested slight overall internal rotation with complete resection of the ligaments, with a change < 2mm - threshold which corresponds to the commonly used buffer to account for physiologic laxity as per clinical judgment of the surgeon. Excellent agreement (>0.90) was found between the two independent observers for each of the parameters in both 2D and 3D (overall ICC 0.9968, 95% CI 0.995 - 0.999). Conclusions: The 3D CIOS CBCT appears to reliably depict the trend in TFO and TCS. This might be due to the additional detection of relevant rotational malpositions of the fibula in comparison to the standard 2D fluoroscopy which is limited to a single plane translation. A better understanding of 3D imaging may help surgeons identify the precise measurements planes needed to achieve better syndesmosis repair.

Keywords: 2D fluoroscopy, 3D computed tomography, image processing, syndesmosis injury

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Authors: Faruk Emir, Simel Ayyıldız, Cem Şahin

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Behçet’s disease or Behçet’s syndrome is a chronic and multi-systemic inflammatory disease of unknown cause. This syndrome often presents with mucous membrane ulceration and ocular problems. As a systemic disease Behcet includes triple-symptom complex of recurrent oral aphthous ulcers, genital ulcers, and uveitis. Nearly all patients present with some form of painful oral mucocutaneous ulcerations in the form of aphthous ulcers. The aim of the treatment plan for Behçet’s Disease patients is to eliminate oral problems and increase the patient comfort.This clinical report represents the prosthodontic rehabilitation of Behcet’s disease patients mandibular total edentulism with the use of implant supported prosthesis that planned on custom abutments and bar retainers via CAD/CAM technology and patient satisfaction has been achieved in function and aesthetics.

Keywords: Behçet’s disease, CAD/CAM, custom-made manufacturing, titanium milled bar retainer

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Authors: Fahad R. Choudhry., Khadeeja Munawar

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This clinical case presents a 24 years old, Muslim Pakistani girl with a history of conversion disorder. Her symptoms comprised fits, restlessness, numbness in legs, poor coordination and balance, burning during urination and retention. A cognitive-behavioral model was used for conceptualizing her problem and devising a management plan based on cognitive behavioral therapy (CBT) and culturally adapted coping statements. She took 13 therapy sessions and was presented with idiosyncratic case conceptualization. Psychoeducation, coping statements, extinction, verbal challenging, and behavioral activation techniques were practiced in a collaborative way for cognitive restructuring of the client. Focus of terminal sessions was on anger management. The client needed a couple of more sessions in order to help her manage her anger. However, the therapy was terminated on the part of the client after attainment of short term goals. The client reported to have a 75 % improvement in her overall condition and remained compliant throughout the therapy.

Keywords: cognitive behavioral therapy, conversion disorder, female, Muslim, Pakistani

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Authors: Catherine McWhorter

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Robotics is a fast-evolving field lacking comprehensive and harm-mitigating regulation; it also lacks critical data on how human-robot interaction (HRI) may affect human psychology. As most anthropomorphic robots are intended as substitutes for humans, this paper asserts that the commercial robotics industry should be preemptively regulated at the federal level such that robots capable of embodying a victim role in criminal scenarios (“vicbots”) are prohibited until clinical studies determine their effects on the user and society. The results of these studies should then inform more permanent legislation that strives to mitigate risks of harm without infringing upon fundamental rights or stifling innovation. This paper explores these concepts through the lens of the sex robot industry. The sexbot industry offers some of the most realistic, interactive, and customizable robots for sale today. From approximately 2010 until 2017, some sex robot producers, such as True Companion, actively promoted ‘vicbot’ culture with personalities like “Frigid Farrah” and “Young Yoko” but received significant public backlash for fetishizing rape and pedophilia. Today, “Frigid Farrah” and “Young Yoko” appear to have vanished. Sexbot producers have replaced preprogrammed vicbot personalities in favor of one generic, customizable personality. According to the manufacturer ainidoll.com, when asked, there is only one thing the user won’t be able to program the sexbot to do – “…give you drama”. The ability to customize vicbot personas is possible with today’s generic personality sexbots and may undermine the intent of some current legislative efforts. Current debate on the effects of vicbots indicates a lack of consensus. Some scholars suggest vicbots may reduce the rate of actual sex crimes, and some suggest that vicbots will, in fact, create sex criminals, while others cite their potential for rehabilitation. Vicbots may have value in some instances when prescribed by medical professionals, but the overall uncertainty and lack of data further underscore the need for preemptive regulation and clinical research. Existing literature on exposure to media violence and its effects on prosocial behavior, human aggression, and addiction may serve as launch points for specific studies into the hyperrealism of vicbots. Of course, the customization, anthropomorphism and artificial intelligence of sexbots, and therefore more mainstream robots, will continue to evolve. The existing sexbot industry offers an opportunity to preemptively regulate and to research answers to these and many more questions before this type of technology becomes even more advanced and mainstream. Robots pose complicated moral, ethical, and legal challenges, most of which are beyond the scope of this paper. By examining the possibility for custom vicbots via the sexbots industry, reviewing existing literature on regulation, media violence, and vicbot user effects, this paper strives to underscore the need for preemptive federal regulation prohibiting vicbot capabilities in robots while advocating for further research into the potential for the user and societal harm by the same.

Keywords: human-robot interaction effects, regulation, research, robots

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Authors: Hilal Uslu, Salih Eroglu, Betul Ozkan, Ozcan Bulantekin, Alper Kuscu

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In this study, the strawberry (Fragaria L.) fruits, which were pretreated with ultrasound (US), were worked on in the microwave by using 90W power. Then mathematical modelling was applied to dried fruits by using different experimental thin layer models. The sliced fruits were subjected to ultrasound treatment at a frequency of 40 kHz for 10, 20, and 30 minutes, in an ultrasonic water bath, with a ratio of 1:4 to fruit/water. They are then dried in the microwave (90W). The drying process continued until the product moisture was below 10%. By analyzing the moisture change of the products at a certain time, eight different thin-layer drying models, (Newton, page, modified page, Midilli, Henderson and Pabis, logarithmic, two-term, Wang and Singh) were tested for verification of experimental data. MATLAB R2015a statistical program was used for the modelling, and the best suitable model was determined with R²adj (coefficient of determination of compatibility), and root mean square error (RMSE) values. According to analysis, the drying model that best describes the drying behavior for both drying conditions was determined as the Midilli model by high R²adj and low RMSE values. Control, 10, 20, and 30 min US for groups R²adj and RMSE values was established as respectively; 0,9997- 0,005298; 0,9998- 0,004735; 0,9995- 0,007031; 0,9917-0,02773. In addition, effective diffusion coefficients were calculated for each group and were determined as 3,80x 10⁻⁸, 3,71 x 10⁻⁸, 3,26 x10⁻⁸ ve 3,5 x 10⁻⁸ m/s, respectively.

Keywords: mathematical modelling, microwave drying, strawberry, ultrasound

Procedia PDF Downloads 153

Authors: Biswabandhu Bankura, Srikanta Guria, Madhusudan Das

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Purpose: Thyroid peroxidase (TPO) is the key enzyme in the biosynthesis of thyroid hormones. We aimed to identify the spectrum of mutations in the TPO gene leading to hypothyroidism in the population of West Bengal to establish the genetic etiology of the disease. Methods: 200 hypothyroid patients (case) and their corresponding sex and age matched 200 normal individuals (control) were screened depending on their clinical manifestations. Genomic DNA was isolated from peripheral blood samples and TPO gene (Exon 7 to Exon 14) was amplified by PCR. The PCR products were subjected to sequencing to identify mutations. Results: Single nucleotide changes such as Glu 641 Lys, Asp 668 Asn, Thr 725 Pro, Asp 620 Asn, Ser 398 Thr, and Ala 373 Ser were found. Changes in the TPO were assayed in vitro to compare mutant and wild-type activities. Five mutants were enzymatically inactive in the guaiacol and iodide assays. This is a strong indication that the mutations are present at crucial positions of the TPO gene, resulting in inactivated TPO. Key Findings: The results of this study may help to develop a genetic screening protocol for goiter and hypothyroidism in the population of West Bengal.

Keywords: thyroid peroxidase, hypothyroidism, mutation, in vitro assay, transfection

Procedia PDF Downloads 345

Authors: Biswabandhu Bankura, Srikanta Guria, Madhusudan Das

Abstract:

Purpose: Thyroid peroxidase (TPO) is the key enzyme in the biosynthesis of thyroid hormones. We aimed to identify the spectrum of mutations in the TPO gene leading to hypothyroidism in the population of West Bengal to establish the genetic etiology of the disease. Methods: 200 hypothyroid patients (case) and their corresponding sex and age matched 200 normal individuals (control) were screened depending on their clinical manifestations. Genomic DNA was isolated from peripheral blood samples and TPO gene (Exon 7 to Exon 14) was amplified by PCR. The PCR products were subjected to sequencing to identify mutations. Results: Single nucleotide changes such as Glu 641 Lys, Asp 668 Asn, Thr 725 Pro, Asp 620 Asn, Ser 398 Thr, and Ala 373 Ser were found. Changes in the TPO were assayed in vitro to compare mutant and wild-type activities. Five mutants were enzymatically inactive in the guaiacol and iodide assays. This is a strong indication that the mutations are present at crucial positions of the TPO gene, resulting in inactivated TPO. Key Findings: The results of this study may help to develop a genetic screening protocol for goiter and hypothyroidism in the population of West Bengal.

Keywords: thyroid peroxidase, hypothyroidism, mutation, in vitro assay, transfection

Procedia PDF Downloads 335

Authors: K. K. Lee, H. W. Han, H. L. Kang, T. A. Kim, S. H. Han

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For the robust optimization of the manufacturing product design, there are design objectives that must be achieved, such as a minimization of the mean and standard deviation in objective functions within the required sensitivity constraints. The authors utilized the sensitivity of objective functions and constraints with respect to the effective design variables to reduce the computational burden associated with the evaluation of the probabilities. The individual mean and sensitivity values could be estimated easily by using the 9 level orthogonal array based response surface models optimized by the stepwise regression. The present study evaluates a proposed procedure from the robust optimization of rubber domes that are commonly used for keyboard switching, by using the 9 level orthogonal array and stepwise regression along with a desirability function. In addition, a new robust optimization process, i.e., the I2GEO (Identify, Integrate, Generate, Explore and Optimize), was proposed on the basis of the robust optimization in rubber domes. The optimized results from the response surface models and the estimated results by using the finite element analysis were consistent within a small margin of error. The standard deviation of objective function is decreasing 54.17% with suggested sensitivity based robust optimization. (Business for Cooperative R&D between Industry, Academy, and Research Institute funded Korea Small and Medium Business Administration in 2017, S2455569)

Keywords: objective function, orthogonal array, response surface model, robust optimization, stepwise regression

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Authors: Soumia Merat, Lynda Djerbal, Ramdane Bahar, Mohammed Amin Benbouras

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Along with shear wave, many soil parameters are associated with the standard penetration test (SPT) as a dynamic in situ experiment. Both SPT-N data and geophysical data do not often exist in the same area. Statistical analysis of correlation between these parameters is an alternate method to estimate Vₛ conveniently and without additional investigations or data acquisition. Shear wave velocity is a basic engineering tool required to define dynamic properties of soils. In many instances, engineers opt for empirical correlations between shear wave velocity (Vₛ) and reliable static field test data like standard penetration test (SPT) N value, CPT (Cone Penetration Test) values, etc., to estimate shear wave velocity or dynamic soil parameters. The relation between Vs and SPT- N values of Algiers area is predicted using the collected data, and it is also compared with the previously suggested formulas of Vₛ determination by measuring Root Mean Square Error (RMSE) of each model. Algiers area is situated in high seismic zone (Zone III [RPA 2003: réglement parasismique algerien]), therefore the study is important for this region. The principal aim of this paper is to compare the field measurements of Down-hole test and the empirical models to show which one of these proposed formulas are applicable to predict and deduce shear wave velocity values.

Keywords: empirical models, RMSE, shear wave velocity, standard penetration test

Procedia PDF Downloads 338

Authors: Sevil Arabaci Tamer, Gonul Gurol, Ibrahim Tekeoglu, Halil Harman, Ihsan Hakki Ciftci

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Neuroserpin (NSP) is a serine protease inhibitor and member of the serpin family. It is expressed in developing and adult nervous systems, and acts as an inhibitor of protease tissue plasminogen activator (tPA) and a regulator of neuronal growth and plasticity. Also NSP displays anti-inflammatory activity. But, its role in rheumatoid arthritis had never been studied before. So, the aim of the present study was to investigate the effect of neuroserpin in patients with RA. A total of 50 frozen (-20 ºC) serum samples 40 of them belonged to patients with RA, and 10 sample belonged to healthy subjects, were enrolled prospectively. We used DAS-28 to evaluate disease activity. The following clinical data gathered from the original patients' charts. Serum neuroserpin levels were measured by enzyme-linked immunosorbent assay. Our preliminary study results demonstrate, for the first time, that NSP levels are significantly different in RA patients relative to healthy subjects (P = 0.014). So, NSP contribute to pathological condition of RA. Thus, we believe that serum NSP levels can be as a marker in patients with RA. However other inflammatory diseases should be further investigated.

Keywords: neuroserpin, rheumatoid arthritis, tPA, tPA inhibitor

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Authors: Neda Azimi, Masoud Rahimi, Faezeh Mohammadi

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Computational fluid dynamics (CFD) simulation was performed to investigate the effect of ferrofluid stimulation on hydrodynamic and mass transfer characteristics of two immiscible liquid phases in a Y-micromixer. The main purpose of this work was to develop a numerical model that is able to simulate hydrodynamic of the ferrofluid flow under magnetic field and determine its effect on mass transfer characteristics. A uniform external magnetic field was applied perpendicular to the flow direction. The volume of fluid (VOF) approach was used for simulating the multiphase flow of ferrofluid and two-immiscible liquid flows. The geometric reconstruction scheme (Geo-Reconstruct) based on piecewise linear interpolation (PLIC) was used for reconstruction of the interface in the VOF approach. The mass transfer rate was defined via an equation as a function of mass concentration gradient of the transported species and added into the phase interaction panel using the user-defined function (UDF). The magnetic field was solved numerically by Fluent MHD module based on solving the magnetic induction equation method. CFD results were validated by experimental data and good agreements have been achieved, which maximum relative error for extraction efficiency was about 7.52 %. It was showed that ferrofluid actuation by a magnetic field can be considered as an efficient mixing agent for liquid-liquid two-phase mass transfer in microdevices.

Keywords: CFD modeling, hydrodynamic, micromixer, ferrofluid, mixing

Procedia PDF Downloads 196

Authors: Lauren Zammerilla Westcott, Ronald C. Jones, James W. Fleshman

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The surgical treatment of breast cancer has rapidly evolved over the past 50 years, progressing from Halsted’s radical mastectomy to a public campaign of surgical options, aesthetic reconstruction, and patient empowerment. This article examines the happenings that led to the transition of breast surgery as a subset of general surgery to its own specialized field. Sparked by the research of Dr. Bernard Fisher and the first National Surgical Adjuvant Breast and Bowel Project trial in 1971, the field of breast surgery underwent significant growth over the next several decades, enabling general surgeons to limit their practices to the breast. High surgical volumes eventually led to the development of the first formal breast surgical oncology fellowship in a large community-based hospital at Baylor University Medical Center in 1982. The establishment of the American Society of Breast Surgeons, as well several landmark clinical trials and public campaign efforts, further contributed to the advancement of breast surgery, making it the specialized field of the current era.

Keywords: breast cancer, breast fellowship, breast surgery, surgical history

Procedia PDF Downloads 133

Authors: Ruth Elvish, Alex Turner, Jen Wells

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Over recent years there has been an increasing interest in the topic of well-being at work, and staff support is an area of continued growth. The present qualitative study explored the impact of a staff well-being service that was specifically attached to a five-year multi-site research programme (the Neighbourhoods and Dementia Study, funded by the ESRC/NIHR). The well-being service was led by a clinical psychologist, who offered 1:1 sessions for staff and co-researchers with dementia. To our knowledge, this service was the first of its kind. Methodology: Interviews were undertaken with staff who had used the service and who opted to take part in the study (n=7). Thematic analysis was used as the method of analysis. Findings: Themes included: triggers, mechanisms of change, impact/outcomes, and unique aspects of a dedicated staff well-being service. Conclusions: The study highlights stressors that are pertinent amongst staff within academic settings, and shows the ways in which a dedicated staff well-being service can impact on both professional and personal lives. Positive change was seen in work performance, self-esteem, relationships, and coping. This exploratory study suggests that this well-being service model should be further trialled and evaluated.

Keywords: academic, service, staff, support, well-being

Procedia PDF Downloads 199

Authors: Juliette Begin, Juliano Colapelle, Andrea Taratanu, Daniel Thirion, Amelie Marsot, Bryan A. Ross

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Chronic obstructive pulmonary disease (COPD), a leading cause of death globally, is characterized by chronic airflow obstruction and acute exacerbations (AECOPDs) that are often triggered by respiratory infections. Pseudomonas aeruginosa (P. aeruginosa), a potentially serious bacterial cause of AECOPDs, is treated with targeted anti-pseudomonal antibiotics. These select few antimicrobials are often used as first-line therapy in patients who are clinically unwell and/or in those suspected of P. aeruginosa-related infection prior to confirmation, potentially contributing to antimicrobial resistance. The present study evaluates prescribing practices in patients with a confirmed sputum history of P. aeruginosa admitted for AECOPD at the McGill University Health Centre (MUHC) and treated with anti-pseudomonal antibiotics. Serum antibiotic concentrations were measured from the same-day peak, trough, and mid-dose blood sampling intervals after reaching steady-state (on or after day 3) and were quantified using ultra-high-performance liquid chromatography (UHPLC). Demographic, clinical, and treatment outcomes were extracted from patient medical charts. Treatment failure was defined by respiratory-related death or mechanical ventilation after ≥3 days of antibiotics; antibiotic therapy extended beyond 2 weeks or a new antibiotic regimen started; or urgent care readmission within 30 days for AECOPD. To date, 9 of 30 planned participants have completed testing: seven received ciprofloxacin, one received meropenem, and one received piperacillin-tazobactam. Due to serum sample batching requirements, the serum ciprofloxacin concentration results for the first 2/8 participants are presented at the time of writing. The first participant had serum levels of 5.45mg/L (T₀), 4.74mg/L (T₅₀), and 4.49mg/L (T₁₀₀), while the second had serum levels of 5mg/L (T₀), 2.6mg/L (T₅₀), and 2.51mg/L (T₁₀₀). Pharmacokinetic parameters Cmax (5.18±0.43mg/L), T₁/₂ (23.56±18.94hours), and AUC (181.9±155.95mg*h/l) were higher than reported monograph values and met target AUC-to-MIC ratio of >125. The patients treated with meropenem and with piperacillin-tazobactam experienced treatment failure. Preliminary results suggest that standard ciprofloxacin dosing in patients experiencing an AECOPD and colonized with P. aeruginosa appears to achieve effective serum concentrations. Final cohort results will inform the pharmacokinetic appropriateness and clinical sufficiency of current AECOPD antimicrobial strategies in P. aeruginosa-colonized patients. This study will guide clinicians in determining the appropriate dosing for AECOPD treatment to achieve therapeutic levels, optimizing outcomes, and minimizing adverse effects. It could also highlight the value of routine antibiotic level monitoring in patients with treatment failure to ensure optimal serum concentrations.

Keywords: acute exacerbation, antimicrobial resistance, chronic obstructive pulmonary disease, pharmacokinetics/pharmacodynamics, Pseudomonas aeruginosa

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Authors: M. Saiful Islam, M. Mohandes, S. Rehman, S. Badran

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Increasing necessity of wind power is directing us to have precise knowledge on wind resources. Methodical investigation of potential locations is required for wind power deployment. High penetration of wind energy to the grid is leading multi megawatt installations with huge investment cost. This fact appeals to determine appropriate places for wind farm operation. For accurate assessment, detailed examination of wind speed profile, relative humidity, temperature and other geological or atmospheric parameters are required. Among all of these uncertainty factors influencing wind power estimation, vertical extrapolation of wind speed is perhaps the most difficult and critical one. Different approaches have been used for the extrapolation of wind speed to hub height which are mainly based on Log law, Power law and various modifications of the two. This paper proposes a Artificial Neural Network (ANN) and Genetic Algorithm (GA) based hybrid model, namely GA-NN for vertical extrapolation of wind speed. This model is very simple in a sense that it does not require any parametric estimations like wind shear coefficient, roughness length or atmospheric stability and also reliable compared to other methods. This model uses available measured wind speeds at 10m, 20m and 30m heights to estimate wind speeds up to 100m. A good comparison is found between measured and estimated wind speeds at 30m and 40m with approximately 3% mean absolute percentage error. Comparisons with ANN and power law, further prove the feasibility of the proposed method.

Keywords: wind profile, vertical extrapolation of wind, genetic algorithm, artificial neural network, hybrid machine learning

Procedia PDF Downloads 490